The persistence of symptoms after biliary tract surgery is distressing to the surgeon and patient alike. The most frequent cause of persistence of symptoms is an incorrect or incomplete diagnosis. When gallstones are found on x-ray examination, it is usual to attribute all symptoms occurring in the upper right quadrant of the abdomen to their presence. It is of the utmost importance that patients with gall-bladder disease undergo a very thorough evaluation before concluding that the gall bladder is their only or even chief problem. Chronic pancreatitis with acute exacerbations; colon malfunction; renal, gastric, and duodenal disease; arthritis, and hiatus hernia are conditions well known to produce symptoms which may be erroneously attributed to the gall bladder.
Of particular interest has been a number of conditions occurring at the sphincter of Oddi. Anomalies in this region have been emphasized by Cole and Grove1 as producing symptoms which have been